Procedures In Cardiac Catheterization Laboratory Research Articles

National Diagnostic Reference Levels of Procedures in Cardiac Catheterization Laboratory in Thailand: A Multi Centers Survey

Background: Diagnostic reference level (DRL) was initially introduced by the International Commission on Radiological Protection, ICRP Publication 73 in 1996. The DRL has been proven to be an effective tool that aids in optimization of protection in the medical exposure of patients for diagnostic and interventional procedures. As the data on the cardiac procedures are limited, particularly in Southeast Asian region, the DRL in cardiac procedures has never been established in this region. Materials and Methods: The survey in cardiac procedures covered 1,102 examinations from three procedures including coronary angiography (CAG), percutaneous coronary intervention (PCI), and permanent pacemaker (PPM) at 10 cardiac centers all over Thailand during 2019. Results: For the CAG procedures, the DRLs of kerma area product (KAP) and air kerma (AK) were 29.3 Gycm² and 395 mGy, respectively. In PCI, DRLs for KAP and AK were 83.7 Gycm² and 1397 mGy respectively. For PPM, the DRLs of KAP and AK were 5.8 Gycm² and 59.0 mGy, respectively. Conclusion: The present report is the first national DRLs on common cardiovascular procedures in Thailand. The results will help the optimization of patient dosages in the cardiac procedures in Thailand and in the neighboring countries, which can be used as the reference. Keywords: Diagnostic reference level; Coronary angiography; Percutaneous coronary intervention

Recent advances in nonoperating room anesthesia for cardiac procedures.

The number of complex procedures performed in the cardiac catheterization laboratory (CCL) is rapidly increasing. Because of their complexity, they frequently require the assistance of an anesthesiologist. The CCL is primarily designed to facilitate a percutaneous cardiac intervention; therefore, it might be a challenging workplace for an anesthesiologist. The aim of this review is to briefly present tasks and challenges of providing anesthesia in the CCL and to provide a concise description of common cardiac procedures performed there. Recent literature indicates that many complicated cardiac procedures can be performed in CCL under monitored anesthesia care. At the same time several of them (e.g. transcatheter aortic valve replacement) are quickly becoming a viable alternative for surgical valve replacement. The most recent expansion of CCL procedures is related to rapidly growing population of grown-ups with congenital heart disease. All aforementioned developments present new challenges to an anesthesiologist. New and fast development of percutaneous cardiac interventions has created a new working place for the anesthesiologist - the CCL. Our expertise in complex cardiac pathophysiology allows conduct of complicated procedures outside of the operating theater. For the same reasons, there is ongoing discussion whether anesthesia support in CCL should be provided by a general or cardiac anesthesiologist.

Infections Associated with Cardiac Catheterization Laboratory Procedures

Infections Associated with Cardiac Catheterization Laboratory Procedures